Efficacy and safety of telmisartan monotherapy in the black hypertensive patient at a tertiary Centre in eastern Nigeria

Abstract

Background. The prevalence of hypertension is increasing globally, and is higher in black patients. In Nigeria the estimated prevalence is 17.6% and affects about 21 million people. End organ damage associated with hypertension is more prevalent and more severe in black patients. Adequate control of blood pressure reduces and sometimes prevents the development of end organ damage associated with hypertension. The use of angiotensin converting enzyme inhibitors and angiotensin receptor blockers in addition to control of blood pressure delays the development of end organ damage associated with hypertension. This study was undertaken to investigate the efficacy and safety of telmisartan as monotherapy in Nigerian black patients with mild to moderate hypertension.
Methods. Adult patients (18 years and above) of both sexes, who were newly diagnosed with mild to moderate hypertension were studied.
Results. There was significant reduction in both systolic and diastolic blood pressures at 4 weeks (9 mmHg and 3 mmHg respectively, p < 0.006), and at 12 weeks (7 mmHg and 6 mmHg respectively, p < 0.016). However only 6 out of 19 (32%) patients who completed the study achieved target blood pressure of ≤ 140/90 mmHg (complete responders). At the end of the study there were 10 (53%) systolic responders (Systolic BP <140 mmHg or ≥ 10 mmHg reduction from baseline), and 11 (58%) diastolic responders (Diastolic BP < 90 mmHg or ≥ 10 mmHg reduction from baseline. Majority of the patients required 80 mg telmisartan for significant blood pressure reduction. There were no significant side effects of the drug recorded in this study.                                                                              Conclusion. It is concluded from this study that telmisartan monotherapy significantly lowers both the systolic and diastolic blood pressures in mild to moderate hypertension in Nigerian black patients. However only about a third of the patient studied achieved target blood pressure of ≤140/90 mmHg with telmisartan monotherapy. Furthermore up to 80% of the patients require 80 mg daily because 40 mg did not control the blood pressure. Telmisartan is safe in Nigerian black patients.

Key words: Angiotensin receptor blocker (ARB): telmisartan – monotherapy – hypertension - African Black – safety.